Wellness Plan Contract - Dental Rider Logo
  • Wellness Plan Dental Rider

  • Wellness Plan Dental Riders provide additional benefits above and beyond those provided by the "base" Wellness Plan. This rider is only available in association with a currently enrolled "base" Wellness Plan and ends if the current Wellness Plan ends or is surrendered. Furthermore, this rider will not be in effect if payment for the current Wellness Plan lapses. This rider is effective Pick a Date*   between   *   *  (*) ("Client") and South Hyland Pet Hospital (also known as NJ Burk Veterinary Services, PLLC). South Hyland Pet Hospital makes available to its clients annual plans for routine dental care as a supplement to annual plans for pet wellness care. Client has had agreed to purchase a one-year Dental Rider in addition to a one-year Wellness Plan of the terms below for Client's pet, *.

  • 1. Dental Plan Selected and Purchased. Client has agreed to purchase the Wellness Plan detailed on Schedule A; Dental Rider.

    2. Cost; Payment for Dental Rider. The cost of the one-year Dental Rider selected by Client includes twelve-installment Monthly Fee payable as follows:

  • Monthly Fee: $95.00 x 12 months = $1140.00 Annual Fee

    Billing Date:   Pick a Date*   

  • The first Monthly Fee is due upon enrollment.  Additional monthly fees will be made by electronic funds transfers via an Automated Clearing House and will be made on a regularly scheduled, recurring basis from Client’s designated bank or credit card.  Payments are due and owing on the selected date above each month commencing the first month after the effective date of this Contract.  Payments owed under this Contract may be prepaid.  There will be no discount or penalty for prepayment.

     

    3. Termination. This Contract may be terminated as follows:

    A. Upon expiration of the 12-month term. 

    B. Upon the occurrence of any of the following: 

    (i) The death of the pet for whom the Plan was purchased

    (ii) At Client’s option if Client relocates more than twenty (20) miles from South Hyland Pet Hospital

    (iii) At the option of Client’s personal representative in the event of Client’s death. 

    If Client has not used any of the services purchased under this Contract and a termination occurs pursuant to this paragraph, all Monthly Fees will be refunded.  No other refunds will be given under any other circumstances.  If Client has used some or all of the services purchased and a termination occurs pursuant to this paragraph, Client shall pay the lesser of:

    (i) The remaining payments owed under the Contract

    (ii) The standard fees charged by South Hyland Pet Hospital for the services used. 

     

    Final payment shall be due within twenty (20) days of termination. 

     

    C. Upon Client’s failure to make any payment owed under this Contract.  If Client has not used any of the services purchased under this Contract and a termination occurs pursuant to this paragraph, no further payments will be owed and no refunds will be given.  If Client has used some or all of the services purchased and a termination occurs pursuant to this paragraph, all remaining payments owed under the Contract are immediately due and payable.  At South Hyland Pet Hospital’s discretion after collection of all amounts owed (including Monthly Fees and collection costs), Client may use services purchased but not yet used.

     

    4. Scope of Plan. 

    A. Client acknowledges that occasionally, due to no fault of South Hyland Pet Hospital, a pet may have an adverse reaction to a vaccine, test, anesthesia or other service purchased under this Contract.  If Client’s pet requires additional veterinary care as a result of an adverse reaction to a service, the purchased plan does not include the cost of any such additional services.  Client agrees to pay for any services required or deemed appropriate as a result of an adverse reaction.

    B. Be advised, this rider provides all services listed on Schedule A. It does not provide for any other services beyond what is included in a routine dental cleaning.

    C. No additional discounts apply for goods and services not specifically described and included on Schedule A.

     

    5. Breach. If Client breaches this Contract, Client will be immediately responsible for all fees owed under this Contract as well as any and all costs incurred in enforcing this Contract, including but not limited to attorneys’ fees and collection costs.

     

    6. Miscellaneous. 

     

    A. Client waives the right to any services or benefits included but not used during the 12-month term of the Plan. No services, benefits or rights of any kind may be carried over to a new term.

    B. Any notice to be given under this Contract must be in writing and personally delivered to South Hyland Pet Hospital or mailed via first class U.S. mail, return receipt requested.  Notice will be considered given upon personal delivery or three business days after deposit in the mail as required above. 

    C. If Client terminates this Contract and later wishes to purchase a new Wellness Plan or Dental Rider, Client will be subject to all terms, conditions and fees of any Wellness Plan or Dental Rider available at such later date.

    D. This Contract is the entire agreement between the parties and may not be changed except by written agreement signed by Client and South Hyland Pet Hospital.

     

    Accordingly, This Dental Rider Contract is effective the date set forth above.

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  • SCHEDULE A

    WELLNESS PLAN DENTAL RIDER

    Services Included:

    One (1)  Complete Dental Cleaning, Scaling and Polishing

    One (1)  Out-Patient Hospital Ward Stay

    One (1)  Pre-Surgical/Anesthetic Examination

    One (1)  Pre-Surgical/Anesthetic Bloodwork: Chemistry Panel, Complete Blood Count (CBC) or Hematocrit (HCT), & +/- a ProBNP Test (based on cardiological risk determined by the attending veterinarian)

    One (1)  Activated Clotting Time

    One (1)  IV Catheterization

    One (1)  IV Fluid Administration

    One (1)  Injectable/Inhalant General Anesthesia 

    One (1)  Anesthetic Safety: Vital Monitoring and Support

    One (1)  Body Temperature/Thermal Support System

    One (1)  Chlorhexidine Oral Antiseptic Treatment

    One (1)  Full Mouth Dental Screening X-Rays

     

     

     

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